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Biomedical subjects

K Rhyner

Publications and source records attributed to K Rhyner.

At least 73 records · Page 4Linked to original sources
PubMed1984

Prognosis in acquired aplastic anemia.

To study prognostic factors 38 consecutive patients with aplastic anemia were evaluated until death or over a follow-up period of at least 4 years. A prognostic formula was devised by multivariate analysis for prediction of short-term survivors at diagnosis of aplastic anemia: Using the initial percentage of nonmyeloid cells in the marrow aspirate and the neutrophil count in peripheral blood, survival of less than 4 months is predicted with a probability of 89% (sensitivity 80%). The lowest blood counts during the course of the disease are useful to predict the outcome in more chronic courses of aplastic anemia: A reticulocytopenia below 5 X 10(9)/1, a neutropenia below 0.1 X 10(9)/1 or a thrombocytopenia below 5 X 10(9)/1 all resulted in an ultimate mortality of over 90%. However, if none of these threshold values were reached, a 4 year survival of 71% was observed. Thus, 5 X 10(9) reticulocytes/1, 0.1 X 10(9) neutrophils/1 and 5 X 10(9) platelets/1 form a group of risk factors to predict a fatal or favorable outcome throughout the course of the disease.

Adolescent↗
PubMed1984

Salicylate prophylaxis in migraine.

46 migraine patients and 4 patients suffering from "nonmigrainous" vascular headache were treated with 250 mg salicylate daily for 2 months. Platelet aggregability before and under treatment was measured in all patients and in 10 controls. The results confirm platelet hyperaggregability in migraine patients and a reduction of aggregability under salicylate out provide no evidence of any significant clinical improvement, thus falsifying the hypothesis of migraine as a platelet aggregation disorder.

Adolescent↗
PubMed1983

[Prevention of vascular complications in polycythemia vera and primary thrombocythemia treated with low doses of acetylsalicylic acid].

22 patients (13 with polycythaemia vera and 9 with primary thrombocythemia) were treated with 250 mg acetylsalicylic acid (ASA) daily for an average of 25 months. Before therapy was started, 3 patients had arterial thromboses, 3 had venous thromboses, 3 had spontaneous hemorrhage, 3 had acral circulatory disorders and 13 had dizziness, whereas under ASA treatment neither arterial nor venous thromboses occurred and only 4 mild spontaneous hemorrhages were recorded. Under ASA the circulatory disorders of the extremities disappeared completely in 11 patients and recurred intermittently in milder form in 2 patients. Dizziness was completely abolished in 12 of the 13 patients. Discontinuation of therapy was followed by prompt recurrence of symptoms. No correlation could be established between symptoms and extent of platelet disease either before or during ASA therapy. Low-dose salicylates are highly effective in the prevention and treatment of vascular complications in polycythaemia vera and primary thrombocythemia. Thanks to ASA, potentially leukemogenic cytostatic agents and radiophosphorus can be used more sparingly.

Aged↗
PubMed1983

[Idiopathic thrombocytopenic purpura: diagnosis and therapy in 46 patients].

The hematological and immunological data of 46 patients with idiopathic thrombozytopenic purpura (ITP) and their response to treatment are reported. The findings are as follows: (1) Antiplatelet antibodies (serum assays) cannot be recommended as a useful diagnostic approach in ITP. (2) Circulating immune complexes are demonstrable in 77% of our patients. (3) The bone marrow contains increased numbers of eosinophils and erythrocytes in about the half of the patients. (4) A "remission" is obtained in 50% of patients with corticosteroids and in 60-80% with splenectomy. Among the immunosuppressants, cyclophosphamide appears to be the most useful. (5) Fatal hemorrhages are very rarely seen in adults with ITP.

Adolescent↗
PubMed1983

[Non-Hodgkin lymphoma of the testis].

Non-Hodgkin's lymphomas of the testis comprise 25-50% of testicular tumors in men over 50 years of age. Using the Rappaport histologic terminology, most testicular lymphomas are of the diffuse histiocytic type. Concomitant involvement of Waldeyer's ring or of paranasal sinuses frequently occurs. Eight patients with primary non-Hodgkin's lymphoma of the testis and 2 patients with a lymphoma which arose in the paranasal sinuses and later involved the testis are reported. The median age of the 10 patients was 57 years. 5 of 8 patients with primary testicular lymphoma were in clinical stage IE. 8 of the 10 patients had diffuse histiocytic lymphoma. Using the Kiel histologic terminology, 4 of these 8 patients had diffuse centroblastic lymphoma and 4 had immunoblastic sarcoma. 5 of the 8 patients with primary testicular lymphoma had complete remission after orchiectomy followed by radio- and/or chemotherapy. The median survival of the 8 patients with primary testicular lymphoma was 30 months. The median survival of patients with complete remission was 44 months and in patients without remission 12 months. Careful staging of patients with testicular lymphoma is of decisive therapeutic and prognostic significance.

Humans↗
PubMed1983

Eosinophilic granuloma of the skeleton with involvement of the lung: a report of three cases.

Three adult patients with chronic bilateral pulmonary infiltrates due to eosinophilic granuloma are described. The diagnosis was based on histologically proven antecedent or concomitant osseous eosinophilic granuloma in all cases. Electron microscopy was performed in two cases, showing abundant Lx-bodies in both. Pulmonary tissue was obtained in the same two cases, yielding eosinophilic granulomas in one and non-specific septal infiltrates in the other. In the third case the assumption of pulmonary eosinophilic granuloma was made by clinical analogy, thus, avoiding lung biopsy. The course was characterized by lasting benefit from skeletal surgery in all patients and by refractoriness of pulmonary lesions to immunodepressants given to two patients. Progression of pulmonary disease was minimal or none during the observation period of four, three, and three years, respectively. Diffuse pulmonary infiltrates may be a manifestation of a covert osseous eosinophilic granuloma. Skeletal screening by x-ray or scintigraphy should be part of the work-up of otherwise unexplained diffuse lung lesions. It may obviate the need for lung biopsy.

Adult↗
PubMed1982

[Clinical staging and course of chronic lymphatic leukemia].

77 patients with chronic lymphocytic leukemia were clinically staged according to a staging system recently proposed by Binet and limited to 3 stages. The 49 patients with stage A disease (not more than 2 areas of palpable nodes or organs) had a median survival time of 141 months; the 17 patients with stage B disease (three or more involved areas) had a median survival time of 71 months and the 11 patients with stage C disease (anemia and/or thrombopenia) had a median survival of 37 months. With this simple three-stage system statistically significant differences of survival between the three groups of patients have been observed. This staging system is useful for the prognostic evaluation of patients with chronic lymphocytic leukemia.

Adult↗
PubMed1982

[Occurrence and clinical relevance of thrombocytosis].

Automated routine platelet counting in 18,602 patients revealed thrombocytosis (platelet count above 400,000/mm3) in 9% (n = 1602) of cases. In 32% of the patients with thrombocytosis an acute or chronic inflammatory process was found, 9% had a malignant tumor and 9% anemia. 6% were alcoholics and 6% had a myeloproliferative syndrome. Chronic gastrointestinal disease was found in 4% and postoperative thrombocytosis in 3% of cases. 32% of the thrombocytosis cases could not be classified under any of the known causes of this disorder. In 51% of the cases the platelet count ranged from 400,000 to 450,000/mm3. Primary thrombocythemia often produced clinical symptoms, whereas secondary thrombocytosis almost always was asymptomatic.

Adolescent↗
PubMed1982

[The value of serum ferritin, serum iron and iron-binding capacity in the differential diagnosis of microcytic hypochromic anemia].

Ferritin, iron, total iron binding capacity and transferrin saturation were measured in the serum of 247 patients with microcytic hypochromic anemia. Differentiation into various categories of microcytic hypochromic anemia was based on clinical criteria and on the response to iron treatment. This produced 147 patients with iron deficiency anemia, 35 patients with anemia secondary to infection, 27 patients with anemia due to tumor and 38 patients with thalassemia. Analysis of the iron parameters revealed the reliability of both serum ferritin and transferrin saturation in distinguishing between the various forms of anemia. However, measurement of serum ferritin is slightly more reliable and much less expensive than determination of transferrin saturation.

Anemia, Hypochromic↗
PubMed1981

Platelet aggregation and beta-thromboglobulin levels in nephrotic patients with and without thrombosis.

Platelet aggregation and beta-thromboglobulin levels were studied in 17 patients with the nephrotic syndrome. Thrombosis or thromboembolic complications occurred in 4 of these patients with serum albumin levels below 2 g/100 ml. Pathologic platelet aggregation assessed by estimating alpha 2-angle values derived from platelet aggregation curves was seen in the 4 patients with thromboembolic complications (alpha 2-angle 69.5 degrees +/- 10.1 degrees), whereas patients without thrombosis showed normal alpha 2-angle values (less than 30 degrees) with only one exception. In addition, patients with thromboembolic complications demonstrated significantly elevated beta-thromboglobulin levels, when compared with those not having thrombosis or thromboembolic complications (76.8 +/- 14.3 ng/ml vs 44.8 +/- 8.6 ng/ml, P less than 0.001). The decrease in serum albumin concentration showed an inverse relationship with both, alpha 2-angle values (r = -0.82, P less than 0.001) and beta-thromboglobulin levels (r = -0.83, P less than 0.001) indicating a regulatory role of serum albumin in platelet aggregation. We conclude, that altered platelet aggregation as well as hypercoagulability may be involved in the pathogenesis of thrombosis and thromboembolic complications in the course of the nephrotic syndrome.

Adult↗
PubMed1979

[Primary thrombocythemia: clinical, pathophysiology and therapeutic possibilities].

The course of primary thrombocythemia has been observed in 22 patients over a period of 1-19 years. In contrast to experience with primary thrombocythemia in the literature, thrombotic complications were far more common than hemorrhage. 20 out of 22 patients complained of pain in toes and fingers due to disturbances of microcirculation, whereas bleeding disorders were present only in 5. Studies on spontaneous aggregation of platelets revealed a close association between platelet hyperaggregability and ischemic attacks. 500 mg acetylsalicylic acid every second day normalized the hyperaggregability in vitro and removed pain completely. The indication for antiaggregating substances in the therapy of primary thrombocythemia is discussed.

Adult↗
PubMed1978

[A safe alternative for the diagnosis of pernicious anemia--a contribution to medical economics (proceedings)].

Mucosal biopsies of corpus and antrum were performed in 17 patients with pernicious anemia. In all patients the corpus mucosa showed atrophic gastritis, while in 16 the antrum was normal or showed only superficial gastritis. This combination is conclusive for pernicious anemia. Over 80% of megaloblastic anemias are caused by pernicious anemia. It is therefore proposed that endoscopy and biopsy be performed as the first examination in these patients. In this way the diagnosis is simple, rapid and economical.

Anemia, Pernicious↗
PubMed1978

[Macrocytic anaemia with folic acid deficiency in hypothyroidism (author's transl)].

Three different kinds of anaemia are seen in hypothyroidism: (1) normocytic, normochromic anaemia; (2) microcytic, hypochromic anaemia; (3) macrocytic normochromic anaemia. The latter is either a true pernicious anemia, which occurs fairly frequently in Hashimoto's thyroiditis, or maturation disorder of erythropoiesis as a result of folic acid deficiency. In three patients with primary hypothyroidism and macrocytic anaemia there were decreased levels of serum folic acid. After short-term administration of folic acid and 1-year of thyroxine the blood picture became normal in two of the patients.

Adult↗